September 5, 2017 : DCMS #361

DISASTERS AVERTED — Near Miss Case Studies

Three Patients, Three Solutions

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

Sood & Messer Part 3, Transitioning from Public Health to Private Practice

HOMERUN SLIDES — Great Clinical Presentation Highlights

Albuminuria: A Lot More Than Just a Little Protein in the Urine Part 3

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #89: Lipid and Lipoprotein Metabolism, Hypolipidemic Agents, and Therapeutic Goals Part 1

MOST POPULAR ARTICLES OF THE MONTH

#1 Coffee Consumption and Mortality: The Final Word
#2 Nonnutritive Sweeteners Linked To Weight Gain
#3 Type 1 Cured in Mice

Last week I was at home and got a call from a physician who I used to see patients for. He was in his late 50s and the ever-increasing workload in his practice had put a damper on his physical activity; therefore, he had gained some weight. This, of course, led to an increase in his A1C and a diagnosis of diabetes. Being that he could self-prescribe, he had decided that he could address weight and glucose levels, so he started on Liraglutide.

This was working for about 6 weeks and then the effect started to wear off. In addition, he was having a lot of trouble at his injection site with redness and itching, and that is why he called me. My first thought was to try a different brand needle, and for him the problem was solved. I am not the only person who gets these questions. This week, in our Disasters Averted series, one educator shares what happened to three of her patients and how she handled them.

A couple of weeks ago we introduced you to our newest Advisory Board Member, Dr. David Leroith, and one of our medical reviewers said that the link to his page was not working. so we wanted to make it available to you once again. Meet Dr. Leroith and other members of our advisory board here.

Dave Joffe

Editor-in-chief

I have had several patients who did well at first with their GLP-1 agonists.

Patient 1: Man, 46 years of age, used liraglutide 3mg daily for obesity.

Patients 2 & 3: 2 women in their 60s were using liraglutide for type 2 diabetes & weight.

Drs. Sood and Messer talk with Diabetes in Control Publisher Steve Freed during the AACE 2017 convention in Austin, Texas about the positives of their practice model and their difference from other physicians.

In this week’s Homerun Slides, the summary of the role of plasma protein (S1P) in glycocalyx protection.

Any discussion of lipid and lipoprotein metabolism in diabetes mellitus, especially type 2 diabetes mellitus (T2DM), must consider the role of insulin resistance (IR). IR plays a central role in the abnormal lipid and lipoprotein metabolism of T2DM [1] as evidenced by the characteristic set of lipid and lipoprotein abnormalities accompanying IR, even in the absence of frank hyperglycemia or abnormal glucose tolerance. Individuals with IR have low plasma levels of HDL-C and elevations in plasma triglyceride (TG) levels compared with levels seen in individuals who have normal insulin sensitivity. There is also an increase in the proportion of low-density lipoprotein (LDL) particles that are small, dense, and cholesterol ester-poor. I

Antioxidants and other polyphenols present in coffee confer healthy benefits to the body, which may include lowering insulin resistance, inflammation and biomarkers of liver function.

Artificial sweeteners may offer short-term weight loss, but at what cost?

Ralph DeFronzo and his researchers at UT Health at San Antonio announced that they have cured type 1 diabetes.